Initiative Petition 1 is a statutory proposal that establishes certain minimum
educational and training requirements as a condition of performing what the measure
defines as "high velocity, low amplitude" spinal manipulation and adjustment. Under the
proposed measure, health professional regulatory boards, as specified in ORS 676.160,
may suspend, revoke, or refuse to renew the license or registration of a person under their
jurisdiction who performs such spinal manipulations without the requisite education and
training. Likewise under the proposed measure, the board that regulates athletic trainers
(who are not covered under ORS 676.160) may suspend, revoke, or refuse to renew an
athletic trainer's license or registration if he or she performs "high velocity, low
amplitude" spinal manipulations without the requisite education and training.

The Attorney General certified the following ballot title for Initiative
Petition 1:

"RESULT OF 'NO' VOTE: 'No' vote makes no changes to training and educational requirements for spinal manipulation and adjustments by
different professions; requirements remain set by respective licensing
boards.

"SUMMARY: Current law contains statutes, rules and regulations
governing the scope of practice of health care practitioners, including
chiropractors and athletic trainers. Measure prohibits persons from
performing 'high velocity, low amplitude spinal manipulation or
chiropractic spinal adjusting' (defined) without having: legal authority to
perform 'differential diagnosis' (defined) in Oregon; 400 hours of hands-on
instruction in spinal manipulation and adjustments; 900 hours of clinical
training directly supervised by licensed physician over at least twelve
months. Measure makes performance of spinal manipulation and
adjustments unlawful chiropractic practice and grounds for a health
professional regulatory board having authority over a health care
practitioner or the Board of Athletic Trainers to suspend, revoke or refuse
to renew a license or registration or impose other lawful disciplinary action.
Other provisions."

Petitioner challenges only the summary prepared by the Attorney General
for the proposed measure. ORS 250.035(2)(d) requires that the summary contain "[a]
concise and impartial statement of not more than 125 words summarizing the state
measure and its major effect." Petitioner advances two independent challenges to the
adequacy of the summary, which we consider in turn.

Petitioner's first challenge is that the description of current law in the
summary is unhelpful, because merely stating that existing "statutes, rules and
regulations" govern the scope of practice of health care practitioners provides no useful
information to voters. In petitioner's view, that problem is compounded because the
summary singles out chiropractors and athletic trainers and, by doing so, suggests that
they are the only professionals affected by the proposal. The Attorney General does not
directly respond to petitioner's concern that the summary's reference to current law is too
generic. As for petitioner's claim that the summary singles out chiropractors and athletic
trainers, the Attorney General urges that, because the summary refers to "health care
providers, including chiropractors and athletic trainers" (emphasis added by Attorney
General), the summary adequately explains that health care providers more generally are
affected by the proposed measure. The Attorney General defends the specific reference
to chiropractors and athletic trainers because the proposed measure itself specifically
includes those groups by extending its scope to the regulatory board that oversees athletic
trainers and by declaring that a violation of the statutory prohibition is an unlawful
"chiropractic practice."

Petitioner's second challenge to the summary is that it does not accurately
describe the major effect of the proposed measure because it does not explain that, at
present, "only chiropractors receive [the] specified kind of training" that the measure
requires. Petitioner urges that the real effect of the measure will be to give chiropractors
"a monopoly" over spinal manipulation therapy and make it unlawful for other health
care professionals to provide the same therapy.

The proposed measure, however, does no more than establish minimum
levels of training and education that health care professionals and athletic trainers must
meet as a condition of performing the described spinal manipulation therapy. It does not
require that a person be a licensed chiropractor to perform that therapy. Whether other
health care professionals have obtained, or in the future will obtain, the minimum
training and education that the proposed measure would require cannot be determined
from the terms of the measure itself or from other governing law. We agree with the
Attorney General that petitioner's second ground for challenging the summary requires
speculation that is beyond the scope of the ballot title process. Sizemore v. Myers, 326
Or 220, 230, 953 P2d 360 (1997) ("factual investigation" is well beyond the scope of a
ballot title review).

Ballot title referred to the Attorney General for modification.

APPENDIX

"Be it Enacted by the People of Oregon:

"SECTION 1. (1) As used in this section:

"(a) 'Differential diagnosis' means the determination of which of two or more diseases with similar symptoms is the one from which the patient is suffering.

"(b) 'High velocity, low amplitude spinal manipulation or
chiropractic spinal adjustment' means impulse adjusting or thrusting by the
practitioner's hands of a nature that the patient cannot prevent the motion.
The spinal manipulation or adjustment commences at the point where
mobilization ends and the motion encounters the elastic barrier or
resistance and ends at the limit of anatomical integrity.

"(c) 'Mobilization' means movement applied singularly or
repetitively within or at the physiological range of joint motion, without
imparting a thrust or impulse, with the goal of restoring joint mobility.

"(2) A person may not perform high velocity, low amplitude spinal
manipulation or chiropractic spinal adjustments without having:

"(a) The legal authority to perform differential diagnosis in this
state;

"(b) Received a [sic] least 400 hours of hands-on instruction in
spinal manipulation or spinal adjustment; and

"(c) Received at least 900 hours of clinical training directly
supervised by a licensed physician over a period of at least twelve months.

"(3) Violation of subsection (2) of this section constitutes the
unlawful practice of chiropractic and is grounds for a health professional
regulatory board, as specified in ORS 676.160 and having authority over a
health care practitioner, or the Board of Athletic Trainers to suspend,
revoke or refuse to renew the license or registration of or impose other
disciplinary action allowed by law against the health care practitioner or
athletic trainer who commits the violation.

"SECTION 2. Section 1 of this 2010 Act is not intended to apply
retroactively, and nothing in section 1 of this 2010 Act provides grounds
for disciplinary action against a health care practitioner or an athletic trainer
that are based on conduct occurring before the effective date of this 2010
Act. However, section 1 of this 2010 Act does not prevent a health
professional regulatory board, as specified in ORS 676.160 and having
authority over a health care practitioner, or the Board of Athletic Trainers
from suspending, revoking or refusing to renew the license or registration
of or imposing other disciplinary action allowed by law against a health
care practitioner or athletic trainer on any ground that was the basis for
disciplinary action before the effective date of this 2010 Act.

"SECTION 3. Section 1 of this 2010 Act is added to and made a
part of ORS chapter 684."

3. ORS 676.160 contains an extensive list of regulatory boards that oversee health
care professionals. See,e.g., ORS 676.160(3) (State Board of Clinical Social Workers);
ORS 676.160(6) (Board of Examiners of Licensed Dietitians); ORS 676.160(9) (Board
of Naturopathic Examiners); ORS 676.160(13) (State Board of Pharmacy); ORS
676.160(14) (Board of Medical Examiners); ORS 676.160(16) (Physical Therapist
Licensing Board). As we explain in our answer to petitioner's second challenge to the
summary, neither the proposed measure nor other governing law provides a way to
determine which other licensed health care professionals will be affected by the proposed
measure. The summary therefore does not have to list or specifically identify those other
health care professionals. But it must, better than it does now, explain that the major
effect of the measure is to establish minimum levels of training and education for other
health care professionals, in addition to chiropractors, who now perform or are likely in
the future to perform "high velocity, low amplitude" spinal manipulations.